(1 month ago)
Commons ChamberI thank the Secretary of State for advance sight of his statement, and I thank Baroness Amos and her team for their compassionate work. As I said last week, I pay tribute to the women and families who gave evidence and to the babies at the heart of the inquiry. Many revisited the most painful moments of their lives after years of fighting to be heard. Their courage places a responsibility on us all.
Last week, the House confronted Donna Ockenden’s devastating findings in Nottingham. Today we face the wider national picture. Successive investigations expose the same failures: women dismissed, deterioration missed, staff silenced, inequalities unchallenged and leaders failing to learn. The problem is no longer a lack of evidence; it is a failure to act. Donna Ockenden said this morning that, sadly, so much in this report is stuff that we already knew. She also raised concerns about waiting until December, and I welcome the fact that the Secretary of State has just announced some of the work. She also said that no commissioner alone can fix a system needing action from every level from the Secretary of State right down to every ward. Donna Ockenden commands enormous respect and we should all listen to her, because she is right.
When will the Leeds and Sussex reviews produce their reports, and how will Ministers act on concerns before they conclude, so that families in those areas can see the change that they need as soon as possible? Families should not have to keep proving the scale of harm. Their testimony must now lead to action. The Birth Trauma Association says that the report has overlooked serious injury to women and brain injury to babies, so will the action plan address those harms, and how will families shape and scrutinise it?
We welcome the work beginning immediately on triage, discrimination, staffing and urgent estate risks. This is so important, and we must get on with that work, but families cannot wait until the end of the year for the wider plan. Those expecting babies now need reassurance about what will change and when. So many must be anxious, and we need to do all that we can to reassure them. The new triage standards will be published this week. By when must every trust meet them? Will the Secretary of State commit to update the House, by oral or written statement, on trust-by-trust progress? Will the estates funding include accommodation for parents close to neonatal units so that families are not separated from their critically ill babies?
We do not oppose a statutory maternity and neonatal commissioner, but Ministers must be clear about the role’s purpose, powers and accountability, because just one person cannot bring the change that is needed; local leaders have a responsibility too. When will the commissioner be appointed, and what will they be able to compel trusts, regulators and national bodies to do? How will local leaders be held accountable when care remains unsafe?
The additional midwifery posts are welcome, but temporary roles are not a sustainable workforce plan. Donna Ockenden has warned of rota gaps and of staff leaving obstetrics and midwifery. The 10-year workforce plan has been promised, delayed and pushed back repeatedly. When will it finally be published, and will it provide the permanent workforce that these recommendations require? With women having babies later and pregnancies becoming more complex, how will those at higher risk receive early specialist care?
I agree with the Secretary of State that the culture has to change. Listening to women is a clinical duty, not a courtesy; as I said last week, it is at the core of our safety issues. When concerns are dismissed, warning signs are missed, and mothers and babies are put at risk. That duty must apply equally in respect of every woman. A woman’s safety must not depend on her ethnicity, first language, disability, income or ability to fight through the system. As I said last week, both to the House and to the Secretary of State privately, I want us to work together constructively. Where the Government act with the urgency that the report demands, they will have our full support. We all have a duty, and ours is to support these changes.
Women and families will not judge today by new structures, promises or another report. They will judge it by what happens when a woman says that something is wrong. Is she heard? Are warning signs acted on? Is senior help available when needed? Are maternity units safely staffed? Can staff speak without fear? Do families receive honesty and compassion when harm occurs? Are fewer mothers and babies coming to harm? When decisions are taken, will they be fully explained?
The evidence has been gathered. Families have told their stories. The system has been warned. Now it must change.
I thank the shadow Secretary of State not only for his questions, but for his tone and approach. When I gave the statement about Donna Ockenden’s report last week, we all agreed that the responsibility to deliver real change is shared by everyone in this House, so I appreciate his approach.
The right hon. Gentleman asked about the investigations in Leeds and Sussex, to which Donna Ockenden will be turning her attention over the rest of this year. It might be helpful for the House to understand that in developing a comprehensive action plan through the national taskforce, a framework will be devised so that any recommendations from future reviews can be incorporated into that plan and its implementation. That will ensure that we do not have a situation in which the plan is developed and future reviews come to conclusions or recommendations without a clear way for those to be integrated into the action plan. I hope that that gives him some reassurance over the process.
The right hon. Gentleman spoke about recognising families who have been harmed, as well as babies who survived and have grown up into children and adults while living with the harm of failings in maternity care. I am very conscious of them, not least because of the people I have met who sometimes feel forgotten or feel that their children are forgotten when we have these conversations. They live with the impact of brain injuries or other issues that arise during birth. They must not be forgotten, and I will ensure that they are included in the process.
The right hon. Gentleman asked about the roll-out of the new national triage standards, which will be published this week. The NHS England chief executive is meeting with NHS system leaders today to begin the process of ensuring that the triage standards, along with some of the other urgent measures that I have spoken about today, are rolled out. Although it is right to take time to get the comprehensive action plan in place by the end of the year, we do not want to waste time before we get on with the measures that we have decided should progress more quickly. NHS England leadership is progressing with those today.
The right hon. Gentleman asked about the funding for critical safety works in the maternity estate. Those critical safety measures are important, but the action plan will set out a more comprehensive approach not just for the physical infrastructure, but for the culture, which we have spoken about many times. We cannot invest money in culture in the same way as we can do so in physical infrastructure, but it is something that we need to address. We all agree on that. I sense that I had agreement from the House when I raised the importance of addressing cultural problems in maternity services.
The right hon. Gentleman asked about the responsibility being placed on the commissioner as just one person. I reassure him that my vision is for the commissioner to play a crucial role, but not on their own: they will co-chair the national taskforce with me, help to ensure that the national action plan is implemented, hold the system to account and, crucially, be a voice for women in the system. One way of the Government starting to address the issue of women being ignored in maternity services—an issue I have heard about so many times—is by ensuring that the commissioner is a voice for them when decisions are taken.
The temporary roles are an immediate step this year to ensure that newly qualified midwives have a way into making a contribution to NHS maternity services. Funding for those will be baselined in future years, and trusts will decide, trust by trust, how the funding is distributed among different roles. That will vary depending on needs in local areas.
The right hon. Gentleman also spoke about the importance of identifying women who are at higher risk because of different circumstances or problems they may face in giving birth. That is exactly what I hope the new triage standards will begin to address. If the triage standards can identify issues before they escalate and ensure that women get the right support more quickly, we will have an opportunity to avoid the extra, avoidable harm caused to women by delays in getting the right support.
The shadow Secretary of State closed his remarks by talking again about the need for a change in culture. He talked about the support from the Opposition, who will of course robustly challenge us where appropriate but support the aims that we are seeking to achieve. I thank him for that.
(1 month, 1 week ago)
Commons ChamberI thank the Secretary of State for advance sight of his statement and Donna Ockenden and her team for the care and compassion with which they conducted the review. We had a meeting with her yesterday, and I have to say that it was probably one of the most difficult meetings that I have ever had. I pay tribute to the hon. Member for Sherwood Forest (Michelle Welsh). I can see how deeply personal and painful this is, and I admire her and all her colleagues from the region at what must be a very difficult moment.
Let me say from the outset that I want to be constructive in opposition when it comes to this issue. We need to work together; we have to see improvements. I begin with the women, babies, fathers, partners and families whose lives sit behind the review’s findings. To them, we owe a profound apology for failing them when a family should feel safest, most supported and most able to trust the care around them. For too many, that trust was broken; women were not listened to, families were not believed and warning signs were missed. Some suffered the deepest lost, others were left physically unsafe and others psychologically scarred. No statement can repair that pain, but it can mark the point at which testimony becomes responsibility, and responsibility becomes action.
The painful truth is not only that the failings occurred but that the themes are familiar: women not heard, families dismissed, poor communication, missed deterioration, weak governance and people unable to speak up. Maternity and neonatal safety has challenged Governments of both parties, but it would be wrong to let that history soften the urgency. Women and families are tired of telling their story, hearing promises and seeing the same themes return. The question is whether the system will move because of this review, and so I put three tests to the Secretary of State.
The first is the listening test. Women and families were not consistently listened to. Their concerns were too often dismissed or not acted upon. That is not a soft issue; it is a safety issue. How will the Government embed listening as a clinical discipline? How will trusts measure whether women feel heard? Will complaints and near misses be treated as information for improvement?
The second is the culture test. The review describes bullying, hierarchy and poor psychological safety affecting staff’s decisions and willingness to escalate. I pay tribute to those who were brave enough to do so. In maternity and neonatal care, minutes matter. If staff cannot challenge, safety is weakened. Staff cannot provide the care they want to if they are exhausted or unsupported, or if hierarchy matters more than candour. So I ask: how will boards be held accountable for that ward culture?
The third test is the delivery test. Harm rarely followed one error; it usually followed a chain of poor communication, weak risk assessment, delayed escalation, staff pressure, inadequate governance and missed learning. The response cannot be a single announcement. It must be accompanied by a delivery plan, so will the Secretary of State publish a national implementation plan with named accountability, delivery dates and regular updates to this House? That plan must address the workforce so that staff have the support and information they need to fulfil their roles to the ability they wish.
That plan must design services for today and the future, not rely on assumptions from the past. Women are having children older, pregnancies are more complex and more women are entering pregnancy with pre-existing conditions, previous loss, fertility treatment, mental health needs or circumstances shaping care. That means a need for practical, personalised care, informed choice and each woman being treated as a whole. The review also requires us to confront inequalities. The safety of a patient must not depend on confidence, class, ethnicity, language or an ability to fight through the system. The issue with our mortuaries is also really shocking. The horror stories that we have heard must never happen again. Is the Secretary of State working with colleagues in the Department of Justice to see what more needs to be done to overhaul this area?
Finally, we must recognise the psychological harm caused through silence, poor communication, lack of bereavement support and the battle for honesty. We know that our mortuaries need to have the highest standards. Compassion after harm is not a courtesy; it is a duty. Trust is rebuilt when women feel the difference in the room, when words change decisions, when staff speak without fear, when risk is escalated in time and when boards are judged by results. Where the Government act to improve safety, accountability, staffing and family voice, they will have our support so that we can see this through together. Where they do not, they will face our scrutiny. This review began with families who had to fight to be heard. The task now is to ensure that no family has to fight so hard again.
I thank the shadow Secretary of State for not only the content but the tone of his response, and for the approach that he has taken. I firmly welcome this collaborative approach, because he rightly points out that this is an area that we should work across parties and across this whole House to address. His summary of the key issues that we must address through the work that we are doing—first and foremost, ensuring that women are listened to; the cultural changes we need to see; and the delivery test, recognising that this is a chain of failure—was very well made and in line with where I and the Department are coming at this issue from.
As I mentioned earlier, all the recommendations from today’s report, as well as the recommendations from the national report that Baroness Amos has been working on and from other inquiries and reviews of maternity service failures, will come to the national taskforce that I chair, precisely to deliver that delivery plan—that comprehensive plan of action. We will ensure that it is published by the end of this year, and the Government, working with the Opposition, will ensure that it is delivered across this country.
(1 month, 3 weeks ago)
Commons ChamberI begin by welcoming the Secretary of State and the Under-Secretary of State for Health and Social Care, the hon. Member for Birmingham Edgbaston (Preet Kaur Gill), to their places.
The Secretary of State was in the Treasury when it imposed VAT on compassionate access medicine programmes, which provide some patients—especially children with cancer—with a vital last chance to access treatment. The policy has already led to the closure of one scheme. Will he now commit to abolishing this tax before any more follow suit?
One thing I learned when I was in the Treasury is that decisions about tax are taken by the Chancellor at fiscal events, so I am certainly not going to start taking decisions about taxation in my new role at the Dispatch Box today. The broader point is how important it is to ensure that we have the medicines that we need for the future. That is why this Government are investing so much in research, development and innovation, to ensure that we have the drugs and medicines we need for the healthiest possible population in the future.
I am sorry, but that was simply waffle. This matter needs decisive action now; these drugs are absolutely critical to some children. This cancer drugs tax has already closed one scheme, and companies are making real-time decisions now about whether to continue programmes in the United Kingdom. The Secretary of State must urgently get the Treasury to exempt compassionate use medicines permanently, so that the patients in most need can get these vital drugs, which, in some cases, are simply their only hope.
I have explained the position about decisions on tax. More broadly, it is critical that we have the medicines of the future that we need. One of my very first visits as Secretary of State for Health was to a company that is using AI to determine new opportunities for medicines and drugs to tackle cancers and some of the other illnesses that people face. Making sure that we are investing in businesses—British businesses—to drive that innovation is crucial, not just to the future health of our country but to economic growth.